The State of Care Management in Learning Disability and Mental Health Services 12 Years into Community Care

This paper reports on the organization of care management froma longitudinal study of community care for people resettledfrom long-stay learning disability and psychiatric hospitals.The findings from a 12-year follow-up of care management arrangementsin 12 learning disability and eight mental health study siteservices are described. The diversity of care management arrangementsfound at earlier points in the evaluation remained evident.Also, many of the former ‘care in the community’service users were excluded from mainstream care managementarrangements in their localities. The difficulty of developingperson-centred arrangements in learning disability and the lackof integration of the Care Programme Approach and care managementwere evident. The findings and observations are placed in thewider policy and practice context, with suggestions for takingcare management forward nationally and locally.     

The caring child: an evaluative case study of the Cornwall Young Carers project

This paper reports on an evaluation of the Cornwall Young Carers project (jointly funded by social services and the Cornwall and Isles of Scilly Health Action Zone), conducted during the period 2000–2002. A diverse range of methodological approaches were adopted (comparative national statistics, local pilot study, monthly and quarterly data capturing instruments, and a service user focus group) in monitoring and evaluating the project's high level statements/outcomes. Four evaluative themes are discussed, namely: identification of young carers; assessment of young carers' needs; direct service provision; and partnership working. Recommendations and action steps are proposed with a view of informing future planning and service delivery, as well as developing an ethos of integrating evaluation into everyday practice for the Cornwall Young Carers Project. Overall, the project has made significant progress in meeting and exceeding its original targets. The fact that the project has been able to identify 202 new young carers over this period is a key milestone in demonstrating the critical need for the project's services. It is suggested that existing referrals are only the ‘tip of the iceberg’ for work with young carers in Cornwall.     

Inequality and Democratic Responsiveness

By allowing voters to choose among candidates with competingpolicy orientations and by providing incentives for incumbentsto shape policy in the direction the public desires, electionsare thought to provide the foundation that links governmentpolicy to the preferences of the governed. In this article Iexamine the extent to which the preference/policy link is biasedtoward the preferences of high-income Americans. Using an originaldata set of almost two thousand survey questions on proposedpolicy changes between 1981 and 2002, I find a moderately strongrelationship between what the public wants and what the governmentdoes, albeit with a strong bias toward the status quo. But Ialso find that when Americans with different income levels differin their policy preferences, actual policy outcomes stronglyreflect the preferences of the most affluent but bear virtuallyno relationship to the preferences of poor or middle-incomeAmericans. The vast discrepancy I find in government responsivenessto citizens with different incomes stands in stark contrastto the ideal of political equality that Americans hold dear.Although perfect political equality is an unrealistic goal,representational biases of this magnitude call into questionthe very democratic character of our society.     

Benchmark Analysis: Shopping with Proper Confidence

We discuss the issue of using benchmark doses for quantifying (excess) risk associated with exposure to environmental hazards. The paradigm of low-dose risk estimation in dose-response modeling is used as the primary application scenario. Emphasis is placed on making simultaneous inferences on benchmark doses when data are in the form of proportions, although the concepts translate easily to other forms of outcome data.     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.     

Die Arbeitsgruppe Professionssoziologie und die Randständigkeit der Professionssoziologie im deutschsprachigen Raum

The article analyzes the consequences of the marginal status of the Sociology of Professions in Germany during the last decades on the efforts of the new working group “Sociology of Professions.” This new working group has been established in order to make professions an attractive research topic. First it will be demonstrated that a lack of a solid grounding in the international literature influences the new efforts to publish textbooks. Second it will be shown that there is a missing historical perspective in the old and new sociology of professions in Germany. Finally everything seems to indicate that the new working group is more interested in questions of general sociology and occupational sociology than in questions of a sociology of professions.     

‘The Effect of Social Networks at Origin Communities on Migrant Remittances: Evidence from Nang Rong District’

The literature on the effect of social networks on migrant remittances has ignored the influence of a household’s embeddedness in social networks in the origin community. This paper, using multilevel statistical modeling and social survey data from Nang Rong district in Thailand, examines how remittances between migrants and origin households are associated with social networks. Social network measures come from data on sibling and rice harvest network ties. Rice harvesting is very important to the rural economy, and households participating in the network are privy to vital sources of news and information that spread through the network. Results support the notion that migrants remit less to households that are isolates in the rice-harvesting network, which is theorized to be associated with access to information about employment options.     

MEANINGFUL REGRESSION AND ASSOCIATION MODELS FOR CLUSTERED ORDINAL DATA

Many proposed methods for analyzing clustered ordinal data focus on the regression model and consider the association structure within a cluster as a nuisance. However, the association structure is often of equal interest—for example, temporal association in longitudinal studies and association between responses to similar questions in a survey. We discuss the use, appropriateness, and interpretability of various latent variable and Markov models for the association structure and propose a new structure that exploits the ordinality of the response. The models are illustrated with a study concerning opinions regarding government spending and an analysis of stability and change in teenage marijuana use over time, where we reveal different behavioral patterns for boys and girls through a comprehensive investigation of individual response profiles.